JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Duluth Adult Education - DAE - Step 1 Registration Form
Thank you for your interest in furthering your education with us here at DAE. We are excited to assist you on your educational endeavors! Your journey begins with completing this form.
After you submit this form someone from our office will contact you to give you information on Step 2 to complete your registration.
Please make sure your email and phone number are correct.
Please check your email and voicemail in the next few days to make sure you
receive the information on how to complete your registration
Please note, you must have an address in Duluth, Hermantown, or Proctor to be eligible for our programs. If you live outside of these areas, please use this link to find your nearest adult education school in Minnesota:
https://hotline.mnabe.org/
If you have questions contact 218-336-8725 or
dae@isd709.org
. You must be a Minnesota resident living in the Duluth area to be eligible. Thank you!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Which program are you interested in?
*
GED/Adult Diploma
English as a Second Language (ESL or ELL)
Core/Basic Skills
College Preparation
Career Path
Computer Skills
Other:
If you are interested in a specific class, career pathway, or opportunity, please enter it here.
If no, skip to next question.
You can find our complete class list by
clicking here.
For example:
Ability to Benefit
GED Math Prep Class
Launch into a Trades Career
English Conversation Class
English Vocab for Driver's Manual
College Prep Math Essentials 1
TEAS Exam Prep
Driver's Written Exam Prep
Paraprofessional
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Middle Name
Your answer
Nick Name/Preferred Name
Your answer
Pronouns (she/her, he/him, they/them, etc.)
Your answer
Email
*
Your answer
Primary Phone
*
Your answer
Street Address
*
Your answer
City, State, Zip County
Please note: You must have an address in Duluth, Hermantown, or Proctor to be eligible for our programs.
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Age
Your answer
Gender:
*
Female
Male
Other Gender Identity
Hispanic
*
Yes
No
Race (Choose only one)
*
American Indian - Alaskan Native
Asian
White
Native Hawaiian - Other Pacific Islander
Black or African American
Two or More Races
Work Status (Choose only one)
*
Employed
Employed - To be terminated or Separated
Not in Labor Force
Unemployed
Do you receive public assistance? (Choose only one)
*
None
SSI
SNAP
MFIP
Other
Highest Formal Education (Choose only one)
*
Grades 1-5
Grades 6-8
Grades 9-12 (No Diploma)
High School Diploma -Alternate Credit
GED- Secondary School Equivalent
Some College - No Degree
College - Professional Degree
No School
What is your country of origin?
Your answer
What is your primary language? For example, English, Spanish, Swahili, Russian, Mandarin, etc.
Your answer
Education Location
*
U.S.A
NON - U.S.A.
Factors that challenge you to meet your educational or career goals (Check all that apply)
Foster Care
Disabled
Displaced Homemaker
Ex-Offender
Migrant Worker
Homeless
Learning Disabled
Low Income
Single Parent
None of the above
Which items below would help support you meeting your educational or career goals? (check all that apply)
TRANSPORTATION - we offer free bus passes to eligible students
PARKING- we offer free parking to eligible students
CHILDCARE- we offer childcare options through the YMCA and Community Action Duluth
CHROMEBOOK- we offer a chromebook loan program for eligible and active students
A QUIET PLACE TO STUDY- we offer tutor time for all registered DAE students
IMPROVE COMPUTER SKILLS- we offer programs to build computer skills for all registered DAE students
GET PAID TO STUDY FOR YOUR GED- For students ages 18 - 24 only
How did you hear about our program?
Online/Google Search
Referred by a friend or family member
Duluth Public Schools Communication
Referred by CareerForce
Referred by SOAR
Referred by an organization (case manager, AICHO, Teen Challenge, etc.)
Referred by Area Learning Center (ALC)
Community Education Catalog
Social Media
Flyer
Other:
Clear selection
Are you the caregiver/parent/guardian for a student(s) enrolled in K-12, Pre-school, or ECFE through Duluth Public Schools?
YES
NO
Clear selection
Social Security Number: Providing your SSN helps us meet state and federal reporting requirements. We do not share your SSN with anyone.
Your answer
Tennessen Warning: We need to ask you for the following information for our program records: name, birth date, gender, race/ethnic group, employment status. We may share some information with teachers and other staff of Duluth Public Schools. We report this information to the MN Department of Education for annual reporting and funding. We will only share this information with other organizations if you give us permission. Thank you. I have read this:
*
Yes
Thank you for completing the Step 1 Registration information above.
Someone from the DAE office will contact you to give you more information about Step 2 to complete the registration process.
Please check your phone messages and email for information about Step 2 to complete the registration process.
For College Prep
Step 2 includes an additional registration with Lake Superior College.
For Career Path
Step 2 is specific to the career path you are interested in and you will get more information from us when we call.
For GED, Diploma, Core/Basic Skills, and English Language (ESL/ELL)
Step 2 includes in person registration.
Please see your options below for completing Step 2.
For GED, Diploma, Core/Basic Skills, and English Language (ESL/ELL) only:
Please indicate which option works best for you to complete in person Step 2 of registration:
You may skip this question if you are interested in College Prep or Career Path.
GROUP REGISTRATION- 9:00 am every Wednesday at DAE. Plan to be here approximately 3 hours. You will complete additional paperwork, take some assessments, and meet your teacher to get started.
DROP IN REGISTRATION WITH CHILDCARE- 8:30 - 1:00 every Monday, Tuesday, and Thursday at DAE. Plan to be here approximately 2 hours. You will complete some additional paperwork and take some assessments. Your teacher will call you to get started. Childcare available at the downtown YMCA.
EVENING REGISTRATION- 5:00 pm every Wednesday at DAE. Plan to be here approximately 2 hours. You will complete some additional paperwork and take some assessments. Your teacher will call you to get started. (Not available for ESL/ELL students yet.)
EVENING REGISTRATION WITH CHILDCARE- Tues. 4:30 - 7:00 pm at Community Action Duluth (2424 W. 5th St. Duluth 55806). Plan to be here approximately 2 hours. You will complete some additional paperwork and take some assessments. For GED/Diploma students only.
Clear selection
Thank you for taking the time to complete this form. Someone from Duluth Adult Education will contact you to give you more information and answer any questions you have.
Welcome!
Be sure to click the submit button below.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Duluth Public Schools.
Report Abuse
Forms